Chronic total occlusion (CTO) percutaneous coronary intervention is a complex procedure and is associated with considerable risk of complications. Several success and complication scores have been developed; however, data regarding their external validation in other populations such as Latin America are scarce. This study aimed to evaluate the accuracy of the main predictors of success and complications in a broad cohort of procedures in the Latin American (LATAM) CTO registry. From April 2008 to December 2023, 3706 consecutive procedures listed in the LATAM CTO Registry were screened. Of these, 2835 procedures had sufficient information to analyze the J-CTO, PROGRESS, ORA, CL-score, and CASTLE success scores. The complication scores were PROGRESS (MACE, Mortality, and Pericardiocentesis) and OPEN CLEAN. The J-CTO and CASTLE scores demonstrated the highest areas under the curve (AUC) of 0.718 and 0.703, respectively. The AUC value for the CL-score was 0.685, while the PROGRESS score had an AUC of 0.598 and the ORA AUC was 0.545. The level of agreement between scores was low; only 4% of the procedures were classified as difficult or very difficult by all scores and less than 1% were classified as easy by all 5 scores. Among the complication scores, PROGRESS Mortality (AUC 0.651) and PROGRESS MACE (AUC 0.588) showed the best performance, identifying groups with over 10% event rate. These results may improve the selection of revascularization techniques, especially for patient demographics that are historically underrepresented in CTO research.